Iron replacement in hemodialysis patients with a normal serum ferritin level

Deutsche medizinische Wochenschrift
M K Riedel, T Morgenstern

Abstract

Iron deficiency limits the efficacy of recombinant human erythropoietin (rhEPO) therapy in end-stage renal disease patients. Therefore it is essential that serum ferritin levels should be maintened > 200 micro g/l. Functional iron deficiency occurs with serum ferritin levels > 200 micro g/l and transferrin saturation (TFS) lower than 20 %. The purpose of this study was to determine the efficacy of iron therapy in dialysis patients with serum ferritin levels higher than 200 micro g/l. A total of 16 stable patients receiving chronic hemodialysis completed a 6-month survey period. Hemodialysis therapy and weekly subcutaneous rhEPO dose remained unchanged. Patients were divided into three groups according to their TFS, with TFS low (<20 %), barely adequate (20 % < TFS < 25 %) or optimal (>30 %). Sodium ferric gluconate complex (62.5 mg iron) was administered once per week intravenous over 10 minutes at the end of the dialysis. After 3 months, hemoglobin was significantly higher in all groups (10.3 +/- 0.7 g/dl to 12,6 +/- 1.3 g/dl; p < 0,01) with no difference between the three groups and was constant in the following 3 months. Intravenous iron therapy raised ferritin levels significantly after 3 and 6 months: this observation was ...Continue Reading

Citations

Jan 24, 2008·Blood Purification·Han Li, Shi-xiang Wang

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